摘要
目的:观察胸廓内动脉(ITA)参与肝脏肿瘤供血的影像表现和介入治疗效果。材料与方法:4年间发现ITA参与肝癌供血6例,经血管造影证实,男性5例,女1例,年龄36~52岁,均有超声波及CT检查资料,3例曾做MRI检查。既往均曾行肝动脉化疗栓塞(2~8次)。ITA造影用5F眼镜蛇形导管,对向肿瘤供血的ITA分支行栓塞治疗,2例用同轴微导管。结果:肝癌均为巨块型,位于肝脏前部、包膜下,伴有局部肝包膜侵犯3例,6例CT片均显示右侧胸廓内血管影增粗。ITA造影显示均为右侧ITA分支参与肿瘤供血,栓塞治疗均成功。术后CT复查显示肿瘤缩小或/和瘤区碘油积聚增多,末次治疗前αFP>200μg/L3例,术后逐渐降至正常。ITA栓塞后并发胸/腹壁皮肤损伤3例。结论:位于肝脏前部、包膜下的肿瘤可接受ITA供血;在经ITA途径行栓塞治疗时应警惕皮肤损伤并发症。
Objective: To observe imaging features and interventional therapeutic effectiveness of internal thoracic artery (ITA) supply to hepatic tumors.Materials and Methods:Over a 4year period, 6 patients with ITA supply to hepatocellular carcinomas was identified by angiogrphy. 5 men and 1 woman ranged in age from 36 to 52 years. All patients had abdominal ultrasound examination and CT scan, 3 had MR imaging. Transcatheter hepatic artery chemoembolization was done in all 6 patients (2~8 times). ITA arteriography was performed with a 5 french cobrashaped catheter. All arteries supplying to tumor were embolized using lipiodol with anticancer drug. Coaxial microcatheter was used in 2 cases.Results:All lesions were massive type and located in the anterior and subcapsular of the liver. Focal hepatic capsule invasion was found in 3 cases. Enlargement of ITAs was presented on CT in all 6 patients. ITA catheterization revealed that these lesions drew blood supply from right ITA in the six patients. All the tumor supply were successfully embolized. Lesions diminished in size and/or increased lipiodol retention were found on followup CT. 3 patients had an αFP level over 200μg/L prior to ITAs embolization, and returned to normal after embolization. Focal cutaneous damage of the chest and abdominal wall was presented in 3 patients after the treatment.Conclusion: Tumors located anteriorly and superficially in the liver may recruit blood supply through ITA collaterals. Cutaneous damage should be cautious during ITAs embolization.
出处
《临床放射学杂志》
CSCD
北大核心
1998年第1期47-49,共3页
Journal of Clinical Radiology
关键词
肝肿瘤
介入疗法
胸廓内动脉
栓塞疗法
Liver neoplasm Artery, internal thoracic Embolization, therapeutic